Friday, September 17, 2010

Today is the deadline for comments on interim federal regulations on what constitutes a preventive health care service. This is relevant because under the new health care reform law, preventive health care services are to be provided without co-payments and deductibles. Which somehow raises the apparently puzzling question as to whether contraception (defined as methods to prevent pregnancy) is preventive.

Or related to health.

The Obama administration isn't sure about this, and so has asked the Institute of Medicine to study it. This isn't really the question.

The question is: Do men have sex?

Based on substantial empirical evidence, though no new primary research, I assert: They do.

I further assert (and this is recent news as of the last few thousand years) that there are statistically zero pregnancies that occur without the involvement of sperm. This is most commonly supplied by a man known to the prospective mother, but could be supplied through artificial insemination.There were about 4.2 million U.S.births in 2009.

I appreciate that it is women who become pregnant. I appreciate and am an active participant in the women's health movement. There are health conditions that actually occur only in women (cervical cancer) or mostly in women (breast cancer), and gender-related factors that determine female well-being, life chances and longevity.

But I submit that contraception, conception and pregnancy are biological events that involve both males and females; and usually, not to be coy about it, sex.

Now here is how the new regulations will work: Every other on-its-face preventive service will be provided without extra cost-sharing. Starting on Sept. 23.

The Department of Health and Human Services was so eager to get this done that it is issuing interim regulations, meaning we can still submit comments on proposed regulations but meanwhile the interim regs will go into effect. But the Institute of Medicine is going to have to determine whether contraception really is preventive, and related to health, and a service. That will take till August 2011. Then, assuming that they do so affirmatively determine, it will be about another year before you get your IUD, birth control pills -- or vasectomy -- without an additional copay.

We in the women's health movement are going about this all wrong. Contraception is not about protecting women, at least not alone. Contraception is about the rights of men to have sex. In fact, contraception should be the corollary of every prescription for Viagra. In fact, that was the argument Jackie Speier used successfully, when she was a state senator, to get contraception covered by Califormia insurance plans.

Men, whatever else you think about health care reform, I think most of you know and like your female partners. (And LGBT adoptive and assisted technology parents generally feel the same.) You share, at least, the financial and emotional expenses of child-rearing, to say nothing of pregnancy; and if you don't, well, we have laws about that, too. So drop a note by clicking here to the EQUAL Health Network, and we'll let HHS know you know where babies come from. They need your help. You're so big and strong.